- •The interaction between smoking and chemotherapy on survival from ovarian cancer is unknown.
- •Smoking reduced overall and progression-free survival among patients with mucinous ovarian cancer receiving adjuvant chemotherapy.
- •Smoking reduced progression-free survival among all ovarian cancer patients receiving neoadjuvant chemotherapy.
Sunday, November 08, 2015
Saturday, November 07, 2015
Smoking may modify the association between neoadjuvant chemotherapy and survival from ovarian cancer
abstract
Highlights
Abstract
Objective
Tobacco smoking by cancer patients is associated with increased mortality. Less is known of the impact of smoking on recurrence risk and interaction with chemotherapy treatment. We examined these associations in ovarian cancer.Methods
Patients were identified from the Alberta Cancer Registry between 1978 and 2010 and were oversampled for less-common histologic ovarian tumor types. Medical records were abstracted for 678 eligible patients on lifestyle, medical and cancer treatment, and review of pathology slides was performed for 605 patients. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazard models adjusted for age at diagnosis, race, stage and residual disease.Results
Among patients receiving adjuvant chemotherapy (N = 432), current smoking was significantly associated with shorter duration of overall (OS; HR, 8.56; 95% CI, 1.50–48.7) and progression-free (PFS; HR, 5.74; 95% CI, 1.05–31.4) survival from mucinous ovarian cancer only. There was no significant association between neoadjuvant chemotherapy and survival. However,Where cancers spread to depends on cellular ‘soil prep’
Cancer Research UK - Science blog
As challenges go, understanding how cancers spread around the body is a biggy.
We know the locations tumour cells end up in isn’t random – breast cancer cells tend to head for the lungs, liver, bones or brain, for example.
But how they do this has remained a bit of a mystery.
In 1889, London doctor Stephen Paget planted the idea of ‘seed and soil’. He believed that tumour cells find the body’s ‘fertile ground’, seeding their secondary roots in the tissues that are most welcoming.
It’s a compelling idea, yet many believe it’s too simple a view of the problem.
But a new US study – published in the journal Nature (abstract)– digs deeper into this theory, finessing the idea with some convincing data to back it up.
It turns out that instead of finding already fertile soil, cancer cells might actually be ploughing their own furrow in advance of spreading there. And, crucially, the discovery could one day help make predictions about whether a tumour might spread.
We asked our experts what they thought of the new findings......
Critical Shortage of African American Medical Oncologists in the United States
open access
The Association of American Medical Colleges (AAMC) reported that in 2013 only 2.3% of oncologists in the United States were African American.1 In early 2015, the American Society of Clinical Oncology (ASCO) released 2013 data showing that African Americans will likely continue to be seriously under-represented in medical oncology and that African Americans composed only 4.0% of hematology/oncology fellows in the United States.2 Data from 2012 show a similar pattern for percentages of African American physicians in hematology/oncology in internal medicine (4.0%), pediatric hematology/oncology (4.6%), and radiation oncology (4.2%).3.....
Risk factors for neuroendocrine neoplasms: a systematic review/meta-analysis
open access
(page 7- pdf)
A case-control study of prospectively enrolled patients with pancreatic NEN from Arizona (USA), reported that cases were more likely than controls to have a family member with pancreatic NEN (p=0.024), gallbladder cancer (p=0.024), gastric cancer (p=0.01), sarcoma (p=0.02), and ovarian cancer (p=0.04) [15]. No other consistent associations between pancreatic NEN and cancers at other organ sites were found.
Analysis of Heritability/Shared Heritability Based on Genome-Wide Association Studies for Thirteen Cancer Types
Blogger's Note: not terribly useful without open access
Abstract
Background: Studies of
related individuals have consistently demonstrated notable familial
aggregation of cancer. We aim to estimate
the heritability and genetic correlation
attributable to the additive effects of common single-nucleotide
polymorphisms (SNPs)
for cancer at 13 anatomical sites.
Methods: Between 2007
and 2014, the US National Cancer Institute has generated data from
genome-wide association studies (GWAS) for
49 492 cancer case patients and 34 131 control
patients. We apply novel mixed model methodology (GCTA) to this GWAS
data to
estimate the heritability of individual cancers,
as well as the proportion of heritability attributable to cigarette
smoking
in smoking-related cancers, and the genetic
correlation between pairs of cancers.
Results: GWAS heritability was statistically significant at nearly all sites, with the estimates of array-based heritability, hl
2, on the liability threshold (LT)
scale ranging from 0.05 to 0.38. Estimating the combined heritability of
multiple smoking
characteristics, we calculate that at least 24%
(95% confidence interval [CI] = 14% to 37%) and 7% (95% CI = 4% to 11%)
of
the heritability for lung and bladder cancer,
respectively, can be attributed to genetic determinants of smoking. Most
pairs
of cancers studied did not show evidence of
strong genetic correlation. We found only four pairs of cancers with
marginally
statistically significant correlations,
specifically kidney and testes (ρ = 0.73, SE = 0.28), diffuse large
B-cell lymphoma
(DLBCL) and pediatric osteosarcoma (ρ = 0.53, SE
= 0.21), DLBCL and chronic lymphocytic leukemia (CLL) (ρ = 0.51, SE
=0.18),
and bladder and lung (ρ = 0.35, SE = 0.14).
Correlation analysis also indicates that the genetic architecture of
lung cancer
differs between a smoking population of European
ancestry and a nonsmoking Asian population, allowing for the possibility
that the genetic etiology for the same disease can vary by population and environmental exposures.
Conclusion: Our results provide important insights into the genetic architecture of cancers and suggest new avenues for investigation.
Benefit, Risk, and Outcomes in Drug Development: A Systematic Review of Sunitinib
Abstract
Background: Little is known about the total patient burden associated with clinical development and where burdens fall most heavily during a drug development program. Our goal was to quantify the total patient burden/benefit in developing a new drug.
Methods: We measured
risk using drug-related adverse events that were grade 3 or higher,
benefit by objective response rate, and trial
outcomes by whether studies met their primary
endpoint with acceptable safety. The differences in risk (death rate)
and benefit
(overall response rate) between industry and
nonindustry trials were analyzed with an inverse-variance weighted fixed
effects
meta-analysis implemented as a weighted
regression analysis. All statistical tests were two-sided.
Results: We identified
103 primary publications of sunitinib monotherapy, representing 9092
patients and 3991 patient-years of involvement
over 10 years and 32 different malignancies. In
total, 1052 patients receiving sunitinib monotherapy experienced
objective
tumor response (15.7% of intent-to-treat
population, 95% confidence interval [CI] = 15.3% to 16.0%), 98 died from
drug-related
toxicities (1.08%, 95% CI = 1.02% to 1.14%), and
at least 1245 experienced grade 3–4 drug-related toxicities (13.7%, 95%
CI
= 13.3% to 14.1%). Risk/benefit worsened as the
development program matured, with several instances of replicated
negative
studies and almost no positive trials after the
first responding malignancies were discovered.
Conclusions: Even for a
successful drug, the risk/benefit balance of trials was similar to
phase I cancer trials in general. Sunitinib
monotherapy development showed worsening
risk/benefit, and the testing of new indications responded slowly to
evidence that
sunitinib monotherapy would not extend to new
malignancies. Research decision-making should draw on evidence from
whole research
programs rather than a narrow band of studies in
the same indication.
Prognostic value of 18F-FDG PET/CT volumetric parameters in recurrent epithelial ovarian cancer
abstract
OBJECTIVE:
Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from 18F-FDG PET/CT are emerging prognostic biomarkers in various solid neoplasms. These volumetric parameters and the SUVmax have shown to be useful criteria for disease prognostication in preoperative and post-treatment epithelial ovarian cancer (EOC) patients. The purpose of this study was to evaluate the utility of 18F-FDG PET/CT measurements to predict survival in patients with recurrent EOC.A Systematic Review of Symptoms for the Diagnosis of Ovarian Cancer
Abstract
Context
Ovarian
cancer is common and has significant morbidity and mortality, partly
because it is often diagnosed at a late stage. This study sought to
determine the accuracy of individual symptoms and combinations of
symptoms for the diagnosis of ovarian cancer.
Evidence acquisition
MEDLINE
was searched, identifying 2,492 abstracts, reviewing 71 articles in
full, and ultimately identifying 17 studies published between 2001 and
2014 that met the inclusion criteria......... Data were
analyzed in 2015.
Evidence synthesis
Most
studies were at high risk of bias, primarily because of case-control
design or differential verification bias. The highest positive
likelihood ratios (LRs+) were found for presence of abdominal mass (LR+,
30.0); abdominal distension or increased girth (LR+, 16.0); abdominal
or pelvic pain (LR+, 10.4); abdominal or pelvic bloating (LR+, 9.3);
loss of appetite (LR+, 9.2); and a family history of ovarian cancer
(LR+, 7.5). No symptoms were helpful at ruling out ovarian cancer when
absent. The Ovarian Cancer Symptom Index was validated in five studies
and (after excluding one outlier with different inclusion criteria) was
63% sensitive and 95% specific (LR+, 12.6; LR–, 0.39). Two other symptom
scores had not been validated prospectively.
Conclusions
Several
individual signs and symptoms significantly increase the likelihood of
ovarian cancer when present. More work is needed to validate decision
rules and develop new decision support tools integrating risk factors,
symptoms, and possibly biomarkers to identify women at increased ovarian
cancer risk.
Immunohistochemical characterization of appendiceal mucinous neoplasms and the value of SATB2 in their distinction from primary ovarian mucinous tumors
abstract
AIMS:
The distinction between primary ovarian mucinous tumors and appendiceal mucinous neoplasms metastatic to the ovary can be challenging given the overlap of morphologic features and immunohistochemical expression of traditional markers. SATB2 has been recently described as a sensitive and specific marker of colorectal epithelium. Its expression in appendiceal mucinous tumors and its role in their distinction from ovarian neoplasms have not been fully characterized.CONCLUSIONS:
SATB2 is frequently expressed in appendiceal mucinous neoplasms. In the context of a mucinous neoplasm involving the ovary, any SATB2 positivity should raise the possibility of appendiceal origin. Expression of CK20, CDX2 and MUC2 supports appendiceal origin only when diffuse and strong. These and other markers such as CK7 and PAX8 are recommended in the work-up of ovarian mucinous tumors with any clinical or pathologic features suspicious for secondary origin.
Friday, November 06, 2015
Clinical follow-up and breast and ovarian cancer screening of true BRCA1/2 noncarriers: a qualitative investigation
abstract
PURPOSE:
Most women from BRCA1/2 mutation-positive families who did not inherit the familial mutation have breast and ovarian cancer risks similar to those of women of the same age in the general population. However, recent studies suggest that some of these noncarriers may exhibit screening practices that may be considered as excessive compared to general population screening guidelines. Reasons for such tendencies remain largely unknown. This study aims to better understand how the implications of a noncarrier status are explained to these women and how their own realization of this status affects their screening behaviors.METHODS:
A qualitative study was conducted with five focus groups (n = 28) in Quebec City and Montreal, Canada.Thursday, November 05, 2015
The Fallopian Tube in the 21st Century: When, Why, and How to Consider Removal (open access)
open access - Editorial
In January 2015, based on the available data on ovarian
carcinogenesis and the safety of salpingectomy, both the American
College of Obstetricians and Gynecologists (ACOG) and
the American Cancer Society (ACS) recommended that surgeons should
discuss
the potential benefits of the prophylactic removal of
the Fallopian tubes (FTs) for permanent contraception or during
surgeries
for benign pathologies with every woman at population
risk for ovarian cancer (OC) [1, 2].
This is a potential revolution. Until the end of the 20th century, salpingectomy was considered to be an unworthy appendix
of more complex gynecological surgeries or as an “emergency” measure to treat life-threatening conditions....
Impact of mutational status on survival in low-grade serous carcinoma of the ovary or peritoneum
open access
....Although low-grade serous carcinoma is associated with superior survival outcomes compared with high-grade serous carcinoma and other high-grade ovarian cancers, such as clear cell and high-grade endometrioid subtypes, nevertheless, over 70% of women with low-grade serous carcinoma relapse and ultimately succumb to their cancer. Thus, it is important that we continue to concentrate on better understanding the biology of this rare subtype while concomitantly working toward improving treatment.
AICR: Top Fall Spices for Cancer Prevention (and how to use them)
eNews
Spices, Spices, Spices
Research is looking at the potent phytochemicals in spices and their
role in cancer prevention. Most studies use far higher amounts then you
would eat, but spices can transform an entire dish with the power of a
pinch or a teaspoon.
Try these five spices in your cooking to add flavor to your cancer-protective meals.
Try these five spices in your cooking to add flavor to your cancer-protective meals.
Know Your Risk: (quiz) low white blood cell count/infections during chemo
CDCF PCI
Your answers to a few questions will help estimate your risk for developing a low white blood cell count (a condition called neutropenia) and infections during your chemotherapy. This risk is highest when your white blood cell count is at its lowest.
Click on the appropriate link below to take the test:
Know the Actions You Can Take to Protect Yourself
Since a fever may be your body's only sign of an infection,
it's very important that you call your doctor immediately
if you have a temp of 100.4 F or higher for more than 1 hour, or a
one-time temp of 101 F or higher.
Subscribe to:
Posts
(
Atom
)
